Healthy range for serum ALT and the clinical significance of "unhealthy" normal ALT levels in the Korean population

Journal of Gastroenterology and Hepatology (Australia)

Volumn 26, Issue 2, 2011, Pages 292-299

  Kang, Hyun Seok ^a   Um, Soon Ho ^a   Seo, Yeon Seok ^a   An, Hyonggin ^a   Lee, Kwang Gyun ^a   Hyun, Jong Jin ^a   Kim, Eun Sun ^a   Park, Sung Chul ^a   Keum, Bora ^a   Kim, Ji Hoon ^a   Yim, Hyung Joon ^a   Jeen, Yoon Tae ^a   Lee, Hong Sik ^a   Chun, Hoon Jai ^a   Kim, Chang Duck ^a   Ryu, Ho Sang ^a  

^a Korea University College of Medicine   (South Korea)

Author keywords

Aminotransferase; Insulin resistance; Metabolic syndrome; Non alcoholic fatty liver disease

Indexed keywords

ALANINE AMINOTRANSFERASE;

ADULT; ARTICLE; COHORT ANALYSIS; CONTROLLED STUDY; FEMALE; HEALTH PROMOTION; HUMAN; INSULIN RESISTANCE; LABORATORY TEST; MAJOR CLINICAL STUDY; MALE; MEDICAL RECORD REVIEW; METABOLIC SYNDROME X; PRIORITY JOURNAL; QUESTIONNAIRE; SOCIAL BEHAVIOR;

EID: 78851470657     PISSN: 08159319     EISSN: 14401746     Source Type: Journal    
DOI: 10.1111/j.1440-1746.2010.06481.x     Document Type: Article

References (37)

1. Alberti A, Morsica G, Chemello L etal. Hepatitis C viraemia and liver disease in symptom-free individuals with anti-HCV. Lancet. 1992; 340: 697-8.
2. Nutt AK, Hassan HA, Lindsey J, Lamps LW, Raufman JP. Liver biopsy in the evaluation of patients with chronic hepatitis C who have repeatedly normal or near-normal serum alanine aminotransferase levels. Am. J. Med. 2000; 109: 62-4.
3. Pradat P, Alberti A, Poynard T etal. Predictive value of ALT levels for histologic findings in chronic hepatitis C: a European collaborative study. Hepatology 2002; 36: 973-7.
4. Liu CH, Lin JW, Tsai FC etal. Noninvasive tests for the prediction of significant hepatic fibrosis in hepatitis C virus carriers with persistently normal alanine aminotransferases. Liver Int. 2006; 26: 1087-94.
5. Puoti C, Magrini A, Stati T etal. Clinical, histological, and virological features of hepatitis C virus carriers with persistently normal or abnormal alanine transaminase levels. Hepatology 1997; 26: 1393-8.
6. Wong VW, Wong GL, Tsang SW etal. Metabolic and histological features of non-alcoholic fatty liver disease patients with different serum alanine aminotransferase levels. Aliment Pharmacol. Ther. 2009; 29: 387-96.
7. Kim HC, Nam CM, Jee SH, Han KH, Oh DK, Suh I. Normal serum aminotransferase concentration and risk of mortality from liver diseases: prospective cohort study. BMJ. 2004; 328: 983.
8. Prati D, Taioli E, Zanella A etal. Updated definitions of healthy ranges for serum alanine aminotransferase levels. Ann. Intern. Med. 2002; 137: 1-10.
9. Krasnoff JB, Painter PL, Wallace JP, Bass NM, Merriman RB. Health-related fitness and physical activity in patients with nonalcoholic fatty liver disease. Hepatology 2008; 47: 1158-66.
10. Diagnosis and classification of diabetes mellitus. Diabetes Care 2008; 31 (Suppl. 1): S55-60.
11. Saverymuttu SH, Joseph AE, Maxwell JD. Ultrasound scanning in the detection of hepatic fibrosis and steatosis. Br. Med. J. 1986; 292: 13-5.
12. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA 2001; 285: 2486-97.
13. The International Association for the Study of Obesity and the International Obesity Task Force. The Asia-Pacific Perspective: Redefining Obesity and Its Treatment. Australia. IASO and IOTF, 2000.
14. Bays HE, Chapman RH, Grandy S. The relationship of body mass index to diabetes mellitus, hypertension and dyslipidaemia: comparison of data from two national surveys. Int. J. Clin. Pract. 2007; 61: 737-47.
15. Pratt DS, Kaplan MM. Evaluation of abnormal liver-enzyme results in asymptomatic patients. N. Engl. J. Med. 2000; 342: 1266-71.
16. Vento S, Nobili V. Aminotransferases as predictors of mortality. Lancet. 2008; 371: 1822-3.
17. Kunde SS, Lazenby AJ, Clements RH, Abrams GA. Spectrum of NAFLD and diagnostic implications of the proposed new normal range for serum ALT in obese women. Hepatology 2005; 42: 650-6.
18. Angulo P, Keach JC, Batts KP, Lindor KD. Independent predictors of liver fibrosis in patients with nonalcoholic steatohepatitis. Hepatology 1999; 30: 1356-62.
19. Daniel S, Ben-Menachem T, Vasudevan G, Ma CK, Blumenkehl M. Prospective evaluation of unexplained chronic liver transaminase abnormalities in asymptomatic and symptomatic patients. Am. J. Gastroenterol. 1999; 94: 3010-4.
20. Sheth SG, Gordon FD, Chopra S. Nonalcoholic steatohepatitis. Ann. Intern. Med. 1997; 126: 137-45.
21. Mofrad P, Contos MJ, Haque M etal. Clinical and histologic spectrum of nonalcoholic fatty liver disease associated with normal ALT values. Hepatology 2003; 37: 1286-92.
22. Wong VW, Chan HL, Hui AY etal. Clinical and histological features of non-alcoholic fatty liver disease in Hong Kong Chinese. Aliment Pharmacol. Ther. 2004; 20: 45-9.
23. Fracanzani AL, Valenti L, Bugianesi E etal. Risk of severe liver disease in nonalcoholic fatty liver disease with normal aminotransferase levels: a role for insulin resistance and diabetes. Hepatology 2008; 48: 792-8.
24. Lee TH, Kim WR, Benson JT, Therneau TM, Melton LJ, 3rd. Serum aminotransferase activity and mortality risk in a United States community. Hepatology 2008; 47: 880-7.
25. Saadeh S, Younossi ZM, Remer EM etal. The utility of radiological imaging in nonalcoholic fatty liver disease. Gastroenterology 2002; 123: 745-50.
26. Scatarige JC, Scott WW, Donovan PJ, Siegelman SS, Sanders RC. Fatty infiltration of the liver: ultrasonographic and computed tomographic correlation. J. Ultrasound Med. 1984; 3: 9-14.
27. Choudhury J, Sanyal AJ. Clinical aspects of fatty liver disease. Semin. Liver Dis. 2004; 24: 349-62.
28. Sanyal AJ, Contos MJ, Sterling RK etal. Nonalcoholic fatty liver disease in patients with hepatitis C is associated with features of the metabolic syndrome. Am. J. Gastroenterol. 2003; 98: 2064-71.
29. Dufour DR, Lott JA, Nolte FS, Gretch DR, Koff RS, Seeff LB. Diagnosis and monitoring of hepatic injury. I. Performance characteristics of laboratory tests. Clin. Chem. 2000; 46: 2027-49.
30. Lee JK, Shim JH, Lee HC etal. Estimation of the healthy upper limits for serum alanine aminotransferase in Asian populations with normal liver histology. Hepatology 2010; 51: 1577-83.
31. Chang Y, Ryu S, Sung E, Jang Y. Higher concentrations of alanine aminotransferase within the reference interval predict nonalcoholic fatty liver disease. Clin. Chem. 2007; 53: 686-92.
32. Kerner A, Avizohar O, Sella R etal. Association between elevated liver enzymes and C-reactive protein: possible hepatic contribution to systemic inflammation in the metabolic syndrome. Arterioscler. Thromb. Vasc. Biol. 2005; 25: 193-7.
33. Stedman C. Herbal hepatotoxicity. Semin. Liver Dis. 2002; 22: 195-206.
34. Fraser A, Longnecker MP, Lawlor DA. Prevalence of elevated alanine aminotransferase among US adolescents and associated factors: NHANES 1999-2004. Gastroenterology 2007; 133: 1814-20.
35. Kim HC, Choi KS, Jang YH, Shin HW, Kim DJ. Normal serum aminotransferase levels and the metabolic syndrome: Korean National Health and Nutrition Examination Surveys. Yonsei Med. J. 2006; 47: 542-50.
36. Goessling W, Massaro JM, Vasan RS, D'Agostino RB, Sr, Ellison RC, Fox CS. Aminotransferase levels and 20-year risk of metabolic syndrome, diabetes, and cardiovascular disease. Gastroenterology 2008; 135: 1935-44.
37. Suh SY, Choi SE, Ahn HY, Yang HM, Kim YI, Sung NJ. The association between normal alanine aminotransferase levels and the metabolic syndrome: 2005 Korean National Health and Nutrition Examination Survey. Metabolism 2009; 58: 1731-6.